Provider Demographics
NPI:1558488866
Name:STRAUB, STEPHEN J (PHD, ATC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:J
Last Name:STRAUB
Suffix:
Gender:M
Credentials:PHD, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 MOUNT CARMEL AVE # EC-TRN
Mailing Address - Street 2:QUINNIPIAC UNIVERSITY
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-1905
Mailing Address - Country:US
Mailing Address - Phone:203-582-8443
Mailing Address - Fax:
Practice Address - Street 1:275 MOUNT CARMEL AVE # EC-TRN
Practice Address - Street 2:QUINNIPIAC UNIVERSITY
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-1905
Practice Address - Country:US
Practice Address - Phone:203-582-8443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer